Low-Income Medicaid Beneficiaries Appreciate Physicians Giving Advice About Cessation

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Smoking is highly prevalent among low-income Medicaid beneficiaries and tobacco-cessation benefits are generally available. A newly published study examined the extent to which physicians provide advice to Medicaid patients about quitting. Data from the 2014-2015 Nationwide Adult Medicaid Consumer Assessment of Health Plans survey were merged with state Medicaid policy variables and analyzed.

 

Findings included:

·                  Almost one third (29%) of adult Medicaid beneficiaries smoke.

·                  Almost four fifths of smokers with a personal doctor (77%) say their doctor at least sometimes advised quitting and almost half of smokers discussed cessation medications (48%), or another strategy, such as counseling (42%).

·                  Smokers’ ratings of satisfaction with their physicians and their health plans rose as the frequency of smoking recommendations increased.

·                  Those in Medicaid managed care plans smoked more, but received less advice about cessation medications than those in fee-for-service care.

 

The researchers concluded that findings indicate that patients value prevention-oriented advice and give better ratings to physicians and health plans that offer more support and advice about cessation.

 

Source: Holla et al. (2018). Physicians’ Recommendations to Medicaid Patients About Tobacco Cessation. American Journal of Preventive Medicine, Oct 18. pii: S0749-3797(18)32126-3. doi: 10.1016/j.amepre.2018.07.013. [Epub ahead of print]

Our Tailored Assistance Trainers

 

A major feature of The LOOP is the provision of tailored assistance responsive to grantees’ requests, enabling them to implement more effectively their local tobacco control interventions and initiatives. This is a free service provided to statewide CTCP grantees. Subject matter experts have been identified and recruited to provide trainings and tailored assistance that cover a range of tobacco control topics, as well as other areas pertinent to reaching and serving California’s diverse populations.
 
You can currently make a request for tailored assistance by contacting us at theloop@ucsf.edu. This is a partial list of our tailored assistance trainers and their expertise.

Tobacco Advertising                      American Indian Casinos                            Advertising

Advocacy                                         Educational Materials Development         Evaluation

Community Organizing                Housing and Urban Development             Budget/Fiscal

Faith-Based Organizations           Outdoor Dining, Beaches, Parks                Coalition Build.

Grant Writing                                 Smokeless Tobacco/Cigars                           Fundraising

Health Disparities                          Health Policy Development                        Legal Issues

Leadership Development             Multi-Cultural Issues                                    Social Media

Multi-Unit Housing                        Social Marketing Campaigns                      Tobacco Litter

Research                                          Social Media                                                   Stake Act

Youth Coalition                               Tobacco Control Funding                            Harm Reduction

Combustible and Electronic Tobacco Use Frequently Featured in Popular Hip-Hop Music Videos

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A newly published study assessed the prevalence of the appearance and use of combustible and electronic tobacco and marijuana products, including brand placement, in leading hip-hop songs.

Analysis of top 50 songs from 2013 to 2017 of Billboard magazine’s weekly Hot R&B/Hip-Hop Songs with videos that included the appearance or use of combustible tobacco and marijuana products (manufactured cigarettes, cigars, hookah or waterpipe, pipe, hand-rolled tobacco and marijuana products, marijuana buds); appearance of exhaled smoke or vapor without an identifiable source product; appearance or use of electronic tobacco and marijuana products (eg, electronic cigarettes); tobacco or marijuana brand placement; appearance or use of combustible and electronic tobacco and marijuana by main or featured artist. Data were collected from December 6, 2017, to June 4, 2018.

 

Findings included:

·               The proportion of leading hip-hop videos containing combustible use, electronic use, or smoke or vapor ranged from 40.2% (76 of 189) in 2015, to 50.7% (102 of 201) in 2016.

·               For each year, the leading category of combustible use was hand-rolled products.

·               The appearance of branded products increased from 0% in 2013 (0 of 82) to 9.9% in 2017 (10 of 101) for combustible products, and from 25.0% in 2013 (3 of 12) to 87.5% in 2017 (14 of 16) for electronic products.

·               The prevalence of combustible or electronic product use or exhaled smoke or vapor increased by quartile of total number of views: 41.9% (8700 to 19 million views) among songs in the first quartile of viewership and 49.7% among songs in the fourth quartile of viewership (112 million to 4 billion views).

 

The researchers concluded that the genre’s broad appeal, use of branded products by influential artists, and rise of electronic product and marijuana use may contribute to a growing public health concern of tobacco and marijuana use.

 

Source: Knutzen et al. (2018). Combustible and Electronic Tobacco and Marijuana Products in Hip-Hop Music Videos, 2013-2017. JAMA Internal Medicine, Oct 15. doi: 10.1001/jamainternmed.2018.4488. [Epub ahead of print]

Did You Know? Tobacco Use Is A Major Cardiovascular Risk Factor For American Indians

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Heart disease is the leading cause of death in American Indians (AIs). A newly published study examined cardiovascular risk factors in Northern Plains American Indians undergoing coronary artery bypass grafting surgery. AI patients presented with increased risk factors, including higher rates of diabetes mellitus (AI 63.5% vs. non-AI 38.7%) and smoking/tobacco use (AI 60.8% vs. non-AI 20.0%). The researchers concluded that AIs presented with significantly more risk factors for cardiovascular disease compared with the general population, with especially high rates of insulin-dependent diabetes and active tobacco use.

Source: Anderson et al. (2018). Disparities in Cardiovascular Risk Factors in Northern Plains American Indians Undergoing Coronary Artery Bypass Grafting. Health Equity, Aug 1;2(1):152-160.

Did You Know? Rural Residents Less Supportive Of Secondhand Smoke Restrictions

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A newly published study compared support for secondhand smoke (SHS) restrictions across rural and urban areas. Smoking inside the home was assessed along with attitudes toward smoking in bars, casinos, playgrounds, cars, and cars with kids.

Findings included:

·         Urban respondents were significantly more supportive of all SHS policies: (e.g. smoking in bars [57.9% vs. 51.4%]; support for kids in cars [94.8% vs. 92.5%].

·         Greatest difference between urban-rural residents was in Mid-Atlantic (bar restrictions) and Southeast (home bans): almost 10% less supportive.

·         Rural residents were least likely to support SHS in homes, in cars, on playgrounds and in bars.

·         South Central rural residents were significantly less likely to support SHS policies-home bans, smoking in cars with kids, on playgrounds, in bars and casinos; while Heartland rural residents were significantly more supportive of policies restricting smoking in cars, cars with kids and on playgrounds.

Source: Stillman et al. (2018). Variations in support for secondhand smoke restrictions across diverse rural regions of the United States. Preventive Medicine, Sep 24;116:157-165. doi: 10.1016/j.ypmed.2018.09.014. [Epub ahead of print]

Read the paper at: https://www.sciencedirect.com/science/article/pii/S0091743518302925?via%3Dihub

Did You Know: This Study Explores How To Recruit LGBT Population For Evaluation Of Smoking Intervention “This Free Life”

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Tobacco public education campaigns focus increasingly on hard-to-reach populations at higher risk for smoking, prompting campaign creators and evaluators to develop strategies to reach hard-to-reach populations in virtual and physical spaces where they spend time. A newly published study described two novel recruitment strategies (in-person intercept interviews in lesbian, gay, bisexual, and transgender [LGBT] social venues and targeted social media ads) and compares characteristics of participants recruited via these strategies. Researchers recruited LGBT adults aged 18-24 years in the United States via Facebook and Instagram ads or intercept in LGBT social venues for the survey.

Findings included:

  • Lesbian or gay women, bisexual men and women, gender minorities, and other sexual minorities were more likely than gay men to be recruited via social media (than intercept).
  • Hispanic and other or multiracial, non-Hispanic participants were less likely than white, non-Hispanic participants to be recruited via social media.
  • As age increased, odds of recruitment via social media decreased.
  • Participants with some college education were more likely than those with a college degree to be recruited via social media.
  • Participants who reported past-year pride event attendance were more likely to be recruited via social media.
  • Participants who reported using Instagram at least once daily were less likely to be recruited via social media.
  • Social media recruitment was faster and less expensive (2.2% of combined social media and intercept recruitment cost) but had greater data quality issues-a larger percentage of social media respondents were lost because of duplicate and low-quality responses compared with intercept respondents lost to interviewer misrepresentation.

The researchers concluded that social media combined with intercept provided access to important LGBT subpopulations (e.g., gender and other sexual minorities) and a more diverse sample. Recruiting hard-to-reach populations via audience-tailored strategies enabled recruitment of one of the largest LGBT young adult samples, suggesting these methods’ promise for accessing hard-to-reach populations.

Source: Guillory et al. (2018). Recruiting Hard-to-Reach Populations for Survey Research: Using Facebook and Instagram Advertisements and In-Person Intercept in LGBT Bars and Nightclubs to Recruit LGBT Young Adults. Journal of Medical Internet Research, Jun 18;20(6):e197. doi: 10.2196/jmir.9461.

Did You Know: That Smoking Cessation Interventions That Include Proactive Outreach May Help To Reduce Socioeconomic Disparities In Quitting?

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Population-based smoking-cessation services tend to preferentially benefit high-SES smokers, potentially exacerbating disparities. Interventions that include proactive outreach, telephone counseling, and free or low-cost cessation medications may be more likely to help low-SES smokers quit. A newly published study evaluated the role of SES in smokers’ response to a population-based proactive smoking-cessation intervention. Researchers analyzed data from the Veterans Victory Over Tobacco Study, a smoking-cessation intervention. Findings included that proactive outreach is associated with higher rates of prolonged abstinence among smokers at all SES levels. Proactive outreach interventions that integrate telephone-based care and facilitated cessation medication access have the potential to reduce socioeconomic disparities in quitting.
Source: Danan et al. (2018). The Equity Impact of Proactive Outreach to Smokers: Analysis of a Randomized Trial. American Journal of Preventive Medicine, Aug 20. pii: S0749-3797(18)31934-2. doi: 10.1016/j.amepre.2018.05.023. [Epub ahead of print]

Did You Know: That Higher SES is Linked To Higher Electronic Nicotine Delivery System Use?

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A newly published study investigated the association between socioeconomic status (SES) (education, income, and employment status) and current and former electronic nicotine delivery system (ENDS) use. Researchers analyzed data from the American Heart Association Tobacco Regulatory and Addiction Center (A-TRAC) online survey.

Findings included:

  • College educated persons (vs. those with less than a high school diploma) had a 37% greater prevalence of current ENDS use and a 16% greater prevalence of former ENDS use.
  • Persons with household incomes above $90K (vs. less than $20,000) had a greater prevalence of current and former ENDS use.
  • Those who were employed (vs. not employed) had a 13% greater prevalence of current ENDS use.
  • Higher SES (vs. lower SES) persons were more likely to use ENDS.
Source: Glover et al. (2018). The social patterning of electronic nicotine delivery system use among US adults. Preventive Medicine, Aug 29;116:27-31. doi: 10.1016/j.ypmed.2018.08.038. [Epub ahead of print]

Did You Know? Rural Women Lag Behind Rural Men, Urban Men And Urban Women In Decreasing Smoking

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Smoking prevalence is declining at a slower rate in rural than urban settings in the U.S. and known predictors of smoking do not readily account for this trend difference. A recently published study examined whether smoking trends are different for rural and urban men and women. Researchers analyzed data (n = 303,311) from the U.S. National Survey on Drug Use and Health (NSDUH) from 2007 through 2014 to compare cigarette smoking trends in men and women across rural and urban areas.

 

Findings included:

  • Whereas the smoking trends of rural men, urban men, and urban women significantly declined from 2007 to 2014, the trend for rural women was flat.
  • Controlling for demographic, socioeconomic and psychosocial predictors of smokingdid not explain rural women’s significantly different trend from those of the other three groups.

 

The researchers concluded that rural women lag behind rural men, urban men and urban women in decreasing smoking, a health disparity finding that supports the need for tobacco control and regulatory policies and interventions that are more effective in reducing smokingamong rural women.

New Publication on Rural Health Equity from the National Academies of Sciences, Engineering, and Medicine
Achieving Rural Health Equity and Well-Being: Proceedings of a Workshop (2018)
Rural counties make up about 80 percent of the land area of the United States, but they contain less than 20 percent of the U.S. population. The relative sparseness of the population in rural areas is one of many factors that influence the health and well-being of rural Americans. Rural areas have histories, economies, and cultures that differ from those of cities and from one rural area to another. Understanding these differences is critical to taking steps to improve health and well-being in rural areas and to reduce health disparities among rural populations. To explore the impacts of economic, demographic, and social issues in rural communities and to learn about asset-based approaches to addressing the associated challenges, the National Academies of Sciences, Engineering, and Medicine held a workshop on June 13, 2017. This publication summarizes the presentations and discussions from the workshop.

Did You Know? Waterpipe Tobacco Smoking More Common Among Black And White Latinos Compared To Non-Hispanic Whites

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A recently published study examined intra-ethnic racial differences in waterpipe tobacco smoking (WTS) among Latinos using a nationally representative sample. Researchers analyzed pooled data from the National Adult Tobacco Survey, 2012-2014.

 Findings included:

·         Black Latinos and White Latinos exhibited an increased prevalence of lifetime WTS compared to their non-Hispanic white counterparts.

·         Black Latino men exhibited increased prevalence of lifetime WTS compared to their non-Hispanic white men counterparts. 

·         Black Latinas and white Latinas exhibited increased prevalence of WTS compared to their non-Hispanic white women counterparts.

 The researchers concluded that among the U.S. general adult population, intra-ethnic racial differences in WTS behaviors exist among Latinos; and is shaped by gender. Future efforts to eliminate racial disparities in WTS should be attentive to intra-ethnic racial differences among Latinos.

Source: Ortiz et al. (2018). Intra-Ethnic Racial Differences in Waterpipe Tobacco Smoking among Latinos? Substance Use & Misuse, Jul 20, 1-10. [Epub ahead of print]